A Couple of Items Regarding the American Recovery and Reinvestment Act 2009

Included in the American Recovery and Reinvestment Act, H.R. 1 are two committees that will deal with health care information technology standards and policy. The two committees are the HIT Policy Committee and the HIT Standards Committee.

The HIT Policy Committee is referred to in the Bill as a committee with broad responsibilities. The Bill outlines the committee membership as follows:

IN GENERAL.—The National Coordinator shall provide leadership in the establishment and operations of the HIT Policy Committee.

MEMBERSHIP.—The HIT Policy Committee shall be composed of members to be appointed as follows:

1. One member shall be appointed by the Secretary
2. One member shall be appointed by the Secretary of Veterans Affairs who shall represent the Department of Veterans Affairs
3. One member shall be appointed by the Secretary of Defense who shall represent the Department of Defense
4. One member shall be appointed by the Majority Leader of the Senate
5. One member shall be appointed by the Minority Leader of the Senate
6. One member shall be appointed by the Speaker of the House of Representatives
7. One member shall be appointed by the Minority Leader of the House of Representatives
8. Eleven members shall be appointed by the Comptroller General of the United States, of whom: three members shall represent patients or consumers; one member shall represent health care providers; one member shall be from a labor organization representing health care workers; one member shall have expertise in privacy and security; one member shall have expertise in improving the health of vulnerable populations;one member shall represent health plans or other third party payers; one member shall represent information technology vendors; one member shall represent purchasers or employers; and one member shall have expertise in health care quality measurement and reporting
9. Chairperson and Vice Chairperson - The HIT Policy Committee shall designate one member to serve as the chairperson and one member to serve as the vice chairperson of the Policy Committee. http://thomas.loc.gov/home/approp/app09.html#h1

The HIT Standards Committee

First, a little history on the HIT Standards Committee. The following text was written by John Glaser and posted on www.histalk2.com.

In 2004, the Federal Department of Health and Human Services (HHS) established a series of organizations and initiatives in an effort to further the adoption of interoperable electronic health records (EHRs).

The Healthcare Information Technology Standards Panel (HITSP), the Certification Commission for Healthcare Information Technology (CCHIT), and the Office of the National Coordinator for Healthcare Information Technology (ONC) were established. Demonstrations of aspects of a National Health Information Network (NHIN) were conducted, analyses of privacy regulations were undertaken, and assessments of EHR adoption were performed.

Overseeing all of these activities and organizations was a Federal Advisory Committee, the American Health Information Community (AHIC). You can learn more about all of the above at www.hhs.gov/healthit. AHIC was chaired by the Secretary of Health and Human Services and the committee’s membership was composed of individuals from diverse sectors of healthcare and various HHS agencies and Federal departments.

AHIC was set up to transition, at the end of 2008, to a successor organization. During 2008, the Brookings Institution managed an extensive series of meetings and analyses which involved hundreds of individuals from across healthcare, which designed the successor. This successor was to be a public-private organization and continue the work of the AHIC.

The resulting successor organization is the National eHealth Collaborative (NeHC). You can learn more about NeHC at www.nationalehealth.org.

NeHC is focused on advancing the adoption and effective use of interoperable EHRs. To do that, the NeHC will:

• Use Value Cases to define opportunities to establish interoperability standards. The Value Case approach modifies the AHIC Use Case by performing more upfront analyses to ensure that the standards have a compelling value proposition and are likely to be adopted quickly by the market. In addition, the Value Case approach requires greater participation by healthcare organizations and seeks external funding of the work. It is highly likely that the Value Cases will be broader than transaction standards; Value Cases could also be policy and architecture frameworks and best practices. HITSP and CCHIT would continue their respective roles of interoperability specification development and product certification.
• Develop preliminary strategies and approaches for governing the emerging National Health Information Network.
• Identify barriers to the adoption of interoperable EHRs and commission work designed to overcome those barriers. This work might center on financial incentives, privacy approaches and procedures, data use agreements, and implementation practices.

NeHC will focus on “the ground.” In other words, while NeHC will work with government and industry on policy, its core orientation will be practical – how do we help those of us who are trying implement these systems overcome barriers and have a greater likelihood of improving care?

NeHC is a membership organization. Its members are organizations that have an interest in interoperable EHRs. In the next couple of months, information will be made available that outlines the membership application process and dues structure.

You all should check out the NeHC web site for new developments and announcements. You can also contact me (jglaser@partners.org) or Laura Miller, NeHC Interim Executive Director of NeHC (lmiller@ahicsuccessor.org) with questions and comments.

The Bill outlines a lot information about the HIT Standards Committee but the following is very interesting.

MEMBERSHIP AND OPERATIONS.—

IN GENERAL.—The National Coordinator shall provide leadership in the establishment and operations of the HIT Standards Committee.

MEMBERSHIP.—The membership of the HIT Standards Committee shall at least reflect providers, ancillary healthcare workers, consumers, purchasers, health plans, technology vendors, researchers, relevant Federal agencies, and individuals with technical expertise on health care quality, privacy and security, and on the electronic exchange and use of health information.

BROAD PARTICIPATION.—There is broad participation in the HIT Standards Committee by a variety of public and private stakeholders, either through membership in the Committee or through an

other means.

and later in the bill...

NATIONAL EHEALTH COLLABORATIVE.—Nothing in sections 3002 or 3003 or this subsection shall be construed as prohibiting the National eHealth Collaborative from modifying its charter, duties, membership, and any other structure or function required to be consistent with the requirements of a voluntary consensus standards body so as to allow the Secretary to recognize the National eHealth Collaborative as the HIT Standards Committee.